Medical Radiology and radiation safety Medical Radiology and radiation safety Медицинская радиология и радиационная безопасность 1024-6177 2618-9615 44236 10.12737/1024-6177-2021-66-1-29-36 Радиационная безопасность Radiation safety Радиационная безопасность Radiation Safety in Nuclear Medicine: Report I. Topical Problems РАДИАЦИОННАЯ БЕЗОПАСНОСТЬ В ЯДЕРНОЙ МЕДИЦИНЕ: Сообщение I. АКТУАЛЬНЫЕ ПРОБЛЕМЫ Наркевич Борис Ярославович Narkevich Boris Yaroslavovich medradiol@yandex.ru

доктор технических наук;

doctor of technical sciences;

 Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФ Москва Россия N.N. Blokhin National Medical Research Center of Oncology Moscow Russian Federation Ассоциация медицинских физиков России Москва Россия Association of Medical Physicists of Russia Moscow Russian Federation 66 1 29 36 https://naukaru.ru/en/nauka/article/44236/view

Рассмотрено современное состояние обеспечения радиационной безопасности ядерной медицины в радиологических клиниках России. Проанализированы литературные данные по обеспечению радиационной безопасности пациентов, персонала, отдельных лиц из населения и окружающей среды в подразделениях радионуклидной диагностики и радионуклидной терапии. Сформулированы наиболее важные и требующие своего решения проблемы по обеспечению радиационной безопасности в отечественной ядерной медицине.

The current state and prospects of ensuring radiation safety in the nuclear medicine divisions of Russia are analyzed. The literature data and the main results of our own research to ensure the radiation safety of patients, staff, caregivers and the environment in the departments of radionuclide diagnostics and radionuclide therapy are presented. The most important and requiring solutions to ensure radiation safety in nuclear medicine are considered.

 ядерная медицина радиационная безопасность пациенты персонал население окружающая среда. актуальные проблемы nuclear medicine radiation safety patients personnel population environment topical problems

СанПиН 2.6.1.2523 - 09. Нормы радиационной безопасности НРБ-99/2009. Санитарные правила и нормативы. 2009. [SanPiN 2.6.1.2523 - 09. Radiation Safety Standards NRB-99/2009. Sanitary Rules and Regulations. 2009. (In Russian)]. SanPiN 2.6.1.2523 - 09. Normy radiacionnoy bezopasnosti NRB-99/2009. Sanitarnye pravila i normativy. 2009. [SanPiN 2.6.1.2523 - 09. Radiation Safety Standards NRB-99/2009. Sanitary Rules and Regulations. 2009. (In Russian)]. Публикация 105 МКРЗ. Радиационная защита в медицине. Пер. с англ. С.-Петербург. 2011. [ICRP Publication 105. Radiation Protection in Medicine. 2007. (In Russian)]. Publikaciya 105 MKRZ. Radiacionnaya zaschita v medicine. Per. s angl. S.-Peterburg. 2011. [ICRP Publication 105. Radiation Protection in Medicine. 2007. (In Russian)]. Applying of Radiation Safety Standards in Nuclear Medicine. Safety Reports Series No. 40. IAEA. Vienna. 2005. Applying of Radiation Safety Standards in Nuclear Medicine. Safety Reports Series No. 40. IAEA. Vienna. 2005. Радиологическая защита при медицинском облучении ионизирующим излучением. Серия норм безопасности, № RS-G-1.5. Пер. с англ. МАГАТЭ. Вена. 2004. [Radiological Protection Radiological Protection for Medical Exposure to Ionizing Radiation. Safety Standards Series, No. RS-G-1.5. IAEA. Vienna. 2004. (In Russian)]. Radiologicheskaya zaschita pri medicinskom obluchenii ioniziruyuschim izlucheniem. Seriya norm bezopasnosti, № RS-G-1.5. Per. s angl. MAGATE. Vena. 2004. [Radiological Protection Radiological Protection for Medical Exposure to Ionizing Radiation. Safety Standards Series, No. RS-G-1.5. IAEA. Vienna. 2004. (In Russian)]. МУ 2.6.1.3151-13. Оценка и учет эффективных доз у пациентов при проведении радионуклидных диагностических исследований. Методические указания. М. 2014. [MU 2.6.1.3151-13. Evaluation and Accounting of Effective Doses in Patients During Radionuclide Diagnostic Studies. Guidelines. M. 2014. (In Russian)]. MU 2.6.1.3151-13. Ocenka i uchet effektivnyh doz u pacientov pri provedenii radionuklidnyh diagnosticheskih issledovaniy. Metodicheskie ukazaniya. M. 2014. [MU 2.6.1.3151-13. Evaluation and Accounting of Effective Doses in Patients During Radionuclide Diagnostic Studies. Guidelines. M. 2014. (In Russian)]. https://www.eanm.org/publications/dosage-calculator/ https://www.eanm.org/publications/dosage-calculator/ http://www.snmmi.org/clinicalpractice/pediatrictool.aspx http://www.snmmi.org/clinicalpractice/pediatrictool.aspx Sapienza MT, Willegaignon J. Radionuclide therapy: current status and prospects for internal dosimetry in individualized therapeutic planning. Clinics. 2019;74:e835. DOI: 10.6061/clinics/2019/e835 Sapienza MT, Willegaignon J. Radionuclide therapy: current status and prospects for internal dosimetry in individualized therapeutic planning. Clinics. 2019;74:e835. DOI: 10.6061/clinics/2019/e835 Лысак ЮВ, Климанов ВА, Наркевич БЯ. Количественная сцинтиграфия для контроля доз внутреннего облучения патологических очагов при радионуклидной терапии. Медицинская физика. 2016; (4): 63-71. [Lysak SE, Klimanov VA, Narkevich BYa. Quantitative scintigraphy to control doses of internal exposure to pathological foci during radionuclide therapy. Medical Physycs. 2016; (4): 63-71. (In Russian)]. Lysak YuV, Klimanov VA, Narkevich BYa. Kolichestvennaya scintigrafiya dlya kontrolya doz vnutrennego oblucheniya patologicheskih ochagov pri radionuklidnoy terapii. Medicinskaya fizika. 2016; (4): 63-71. [Lysak SE, Klimanov VA, Narkevich BYa. Quantitative scintigraphy to control doses of internal exposure to pathological foci during radionuclide therapy. Medical Physycs. 2016; (4): 63-71. (In Russian)]. Лысак ЮВ, Гончаров МО, Наркевич БЯ, Ширяев СВ. Применение метода Монте-Карло для повышения точности дозиметрического планирования радионуклидной терапии. Мед. радиол. и радиац. безопасность. 2017; 62(1): 49-55. [Lysak SE, Goncharov MO, Narkevich BY, Shiryaev SV. Application of the Monte Carlo method to improve the accuracy of dosimetric planning of radionuclide therapy. Medical Radiology and Radiation Safety. 2017; 62 (1): 49-55. (In Russian)]. Lysak YuV, Goncharov MO, Narkevich BYa, Shiryaev SV. Primenenie metoda Monte-Karlo dlya povysheniya tochnosti dozimetricheskogo planirovaniya radionuklidnoy terapii. Med. radiol. i radiac. bezopasnost'. 2017; 62(1): 49-55. [Lysak SE, Goncharov MO, Narkevich BY, Shiryaev SV. Application of the Monte Carlo method to improve the accuracy of dosimetric planning of radionuclide therapy. Medical Radiology and Radiation Safety. 2017; 62 (1): 49-55. (In Russian)]. Mango L. Dose-Response Correlation is Possible in Radioiodine Therapy of Hyperthyroidism. Arch Radiol. 2019; 2(2):28-30. Mango L. Dose-Response Correlation is Possible in Radioiodine Therapy of Hyperthyroidism. Arch Radiol. 2019; 2(2):28-30. Chiesa C, Gleisne KS, Flux G, Gear J, Walrand S, et al. The conflict between treatment optimization and registration of radiopharmaceuticals with fixed activity posology in oncological nuclear medicine therapy. Eur J Nucl Med Mol Imaging. 2017. DOI: 10.1007/s00259-017-3707-3. Chiesa C, Gleisne KS, Flux G, Gear J, Walrand S, et al. The conflict between treatment optimization and registration of radiopharmaceuticals with fixed activity posology in oncological nuclear medicine therapy. Eur J Nucl Med Mol Imaging. 2017. DOI: 10.1007/s00259-017-3707-3. ICRP Publication 53. Radiation Dose to Patients from Radiopharmaceuticals. Ann ICRP.1987; 18(1-4). ICRP Publication 53. Radiation Dose to Patients from Radiopharmaceuticals. Ann ICRP.1987; 18(1-4). ICRP Publication 80. Radiation Dose to Patients from Radiopharmaceuticals. Addendum to ICRP 53. Ann ICRP. 1998; 28(3). ICRP Publication 80. Radiation Dose to Patients from Radiopharmaceuticals. Addendum to ICRP 53. Ann ICRP. 1998; 28(3). ICRP Publication 106. Radiation Dose to Patients from Radiopharmaceuticals. A Third Amendment to ICRP 53. Ann ICRP. 2008; 38(1-2). ICRP Publication 106. Radiation Dose to Patients from Radiopharmaceuticals. A Third Amendment to ICRP 53. Ann ICRP. 2008; 38(1-2). ICRP Publication 128. Radiation Dose to Patients from Radiopharmaceuticals. A Compendium of Current Information Related to Frequently Used Substances. Ann ICRP. 2015. 44(2S). ICRP Publication 128. Radiation Dose to Patients from Radiopharmaceuticals. A Compendium of Current Information Related to Frequently Used Substances. Ann ICRP. 2015. 44(2S). ICRP Publication 110. Adult Reference Computational Phantoms. Ann ICRP. 2009; 39(2). ICRP Publication 110. Adult Reference Computational Phantoms. Ann ICRP. 2009; 39(2). Mercuri M, Rehani MM, Einstein AJ. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities. J Nucl Cardiol. 2012 Oct; 19(5): 895-900.DOI: 10.1007/s12350-012-9586-x. Mercuri M, Rehani MM, Einstein AJ. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities. J Nucl Cardiol. 2012 Oct; 19(5): 895-900.DOI: 10.1007/s12350-012-9586-x. ICRP Publication 135. Diagnostic Reference Levels in Medical Imaging. Ann ICRP. 2017; 46(1). ICRP Publication 135. Diagnostic Reference Levels in Medical Imaging. Ann ICRP. 2017; 46(1). ICRP Publication 140. Radiological Protection in Therapy with Radiopharmaceuticals. Ann. ICRP. 2019; 48(1). ICRP Publication 140. Radiological Protection in Therapy with Radiopharmaceuticals. Ann. ICRP. 2019; 48(1). https://www.xrayrisk.com/calculator/select_study.php?id=35 https://www.xrayrisk.com/calculator/select_study.php?id=35 МР 2.6.1.0098-15. Оценка радиационного риска у пациентов при проведении рентгенорадиологических исследований. Методические рекомендации. М. 2012. [MP 2.6.1.0098-15. Assessment of Radiation Risk in Patients During Radiological Studies. Guidelines. M. 2012. (In Russian)]. MR 2.6.1.0098-15. Ocenka radiacionnogo riska u pacientov pri provedenii rentgenoradiologicheskih issledovaniy. Metodicheskie rekomendacii. M. 2012. [MP 2.6.1.0098-15. Assessment of Radiation Risk in Patients During Radiological Studies. Guidelines. M. 2012. (In Russian)]. Alessio AM, Kinahan PE, Manchanda V, Ghioni V, Aldape L, Parisi MT. Weight-Based, Low-Dose Pediatric Whole-Body PET/CT Protocols. J Nucl Med. 2009; 50:1570-8. DOI: 10.2967/jnumed.109.065912. Alessio AM, Kinahan PE, Manchanda V, Ghioni V, Aldape L, Parisi MT. Weight-Based, Low-Dose Pediatric Whole-Body PET/CT Protocols. J Nucl Med. 2009; 50:1570-8. DOI: 10.2967/jnumed.109.065912. Huang B, Wai-Ming M, Khong P-L. Whole-Body PET/CT Scanning: Estimation of Radiation Dose and Cancer Risk. Radiology. 2009 April; 251(1): 166-74. http://radiology.rsnajnls.org/cgi /content/full/2511081300/DC1. Huang B, Wai-Ming M, Khong P-L. Whole-Body PET/CT Scanning: Estimation of Radiation Dose and Cancer Risk. Radiology. 2009 April; 251(1): 166-74. http://radiology.rsnajnls.org/cgi /content/full/2511081300/DC1. Iyer NG, Morris LGT, Tuttle RM, Shaha AR, Ganly I. Rising Incidence of Second Cancers in Patients With Low-Risk (T1N0) Thyroid Cancer Who Receive Radioactive Iodine Therapy. Cancer. 2011 October 1; 117(19): 4439-46. DOI:10.1002/cncr.26070. Iyer NG, Morris LGT, Tuttle RM, Shaha AR, Ganly I. Rising Incidence of Second Cancers in Patients With Low-Risk (T1N0) Thyroid Cancer Who Receive Radioactive Iodine Therapy. Cancer. 2011 October 1; 117(19): 4439-46. DOI:10.1002/cncr.26070. Hieu TT, Russell AW, Cuneo R, Clark J, Kron T, Hall P, Doi SAR. Cancer risk after medical exposure to radioactive iodine in benign thyroid diseases: a meta-analysis. Endocrine-Related Cancer. 2012; 19: 645-55. DOI: 10.1530/ERC-12-0176. Hieu TT, Russell AW, Cuneo R, Clark J, Kron T, Hall P, Doi SAR. Cancer risk after medical exposure to radioactive iodine in benign thyroid diseases: a meta-analysis. Endocrine-Related Cancer. 2012; 19: 645-55. DOI: 10.1530/ERC-12-0176. Fisher DR, Fahey FH. Appropriate Use of Effective Dose in Radiation Protection and Risk Assessment. Health Phys. 2017 August; 113(2): 102-109. DOI:10.1097/HP.0000000000000674. Fisher DR, Fahey FH. Appropriate Use of Effective Dose in Radiation Protection and Risk Assessment. Health Phys. 2017 August; 113(2): 102-109. DOI:10.1097/HP.0000000000000674. Martin CJ. Effective dose: practice, purpose and pitfalls for nuclear medicine. J Radiol Prot. 2011 Jun;31(2):205-19.DOI: 10.1088/0952-4746/31/2/001. Martin CJ. Effective dose: practice, purpose and pitfalls for nuclear medicine. J Radiol Prot. 2011 Jun;31(2):205-19.DOI: 10.1088/0952-4746/31/2/001. Brenner DJ. We can do better than effective dose for estimating or comparing low-dose radiation risk. Ann ICRP. 2012; 41(3/4):124-8. Brenner DJ. We can do better than effective dose for estimating or comparing low-dose radiation risk. Ann ICRP. 2012; 41(3/4):124-8. Fahey FH, Treves ST, Adelstein SJ. Minimizing and Communicating Radiation Risk in Pediatric Nuclear Medicine. J Nucl Med Technol 2012; 40:13-24. DOI: 10.2967/jnumed.109.069609. Fahey FH, Treves ST, Adelstein SJ. Minimizing and Communicating Radiation Risk in Pediatric Nuclear Medicine. J Nucl Med Technol 2012; 40:13-24. DOI: 10.2967/jnumed.109.069609. Vassileva J, Rehani M. Patient grouping for dose surveys and establishment of diagnostic reference levels in paediatric computed tomography. Radiat Prot Dosimetry. 2015 Jul;165(1-4):81-5. DOI: 10.1093/rpd/ncv113. Vassileva J, Rehani M. Patient grouping for dose surveys and establishment of diagnostic reference levels in paediatric computed tomography. Radiat Prot Dosimetry. 2015 Jul;165(1-4):81-5. DOI: 10.1093/rpd/ncv113. Schmidt M, Baum RP, Simon T, Howman-Giles R. Therapeutic nuclear medicine in pediatric malignancy. Q J Nucl Med Mol Imaging. 2010; 54: 411-28. https://www.researchgate.net/publication/46170520. Schmidt M, Baum RP, Simon T, Howman-Giles R. Therapeutic nuclear medicine in pediatric malignancy. Q J Nucl Med Mol Imaging. 2010; 54: 411-28. https://www.researchgate.net/publication/46170520. Наркевич БЯ, Долгушин МБ, Крылов ВВ, Мещерякова НА, Кочетова ТЮ. Радиационно-гигиеническое обеспечения радионуклидной тераностики рака предстательной железы. Медицинская физика. 2020; (1): - .[Narkevich BYa, Dolgushin MB, Krylov VV, Meshcheryakova NA, Kochetova TU. Radiation-hygienic provision of radionuclide theranostics of prostate cancer. Medical Physics. 2020; (1): -. (In Russian)]. Narkevich BYa, Dolgushin MB, Krylov VV, Mescheryakova NA, Kochetova TYu. Radiacionno-gigienicheskoe obespecheniya radionuklidnoy teranostiki raka predstatel'noy zhelezy. Medicinskaya fizika. 2020; (1): - .[Narkevich BYa, Dolgushin MB, Krylov VV, Meshcheryakova NA, Kochetova TU. Radiation-hygienic provision of radionuclide theranostics of prostate cancer. Medical Physics. 2020; (1): -. (In Russian)]. Zanotti-Fregonara P, Hindie E. Performing nuclear medicine examinations in pregnant women. Physica Medica. 2017; 43:159-64. https://doi.org/10.1016/j.ejmp.2017.05.043. Zanotti-Fregonara P, Hindie E. Performing nuclear medicine examinations in pregnant women. Physica Medica. 2017; 43:159-64. https://doi.org/10.1016/j.ejmp.2017.05.043. Martin CJ, Marengo M, Vassileva J, Giammarile F, Poli GL, Marks P. Guidance on prevention of unintended and accidental radiation exposures in nuclear medicine. J Radiol Protection. 2019; 39(3): 43-51. Martin CJ, Marengo M, Vassileva J, Giammarile F, Poli GL, Marks P. Guidance on prevention of unintended and accidental radiation exposures in nuclear medicine. J Radiol Protection. 2019; 39(3): 43-51. ISO 7503-2. Measurement of radioactivity. Measurement and evaluation of surface contamination. Part 2. 2016. ISO 7503-2. Measurement of radioactivity. Measurement and evaluation of surface contamination. Part 2. 2016. Лысак ЮВ, Наркевич БЯ, Рыжов СА. Экстравазальное введение терапевтических радиофармпрепаратов. Медицинская физика 2019; (4):46-51.[Lysak YuV, Narkevich BYa, Ryzhov SA. Extravasal administration of therapeutic radiopharmaceuticals. Medical Physics 2019; (4): 46-51. (In Russian)]. Lysak YuV, Narkevich BYa, Ryzhov SA. Ekstravazal'noe vvedenie terapevticheskih radiofarmpreparatov. Medicinskaya fizika 2019; (4):46-51.[Lysak YuV, Narkevich BYa, Ryzhov SA. Extravasal administration of therapeutic radiopharmaceuticals. Medical Physics 2019; (4): 46-51. (In Russian)]. Radiation Protection in Newer Medical Imaging Techniques: PET/CT. Safety Reports Series No. 58. IAEA. Vienna. 2008. Radiation Protection in Newer Medical Imaging Techniques: PET/CT. Safety Reports Series No. 58. IAEA. Vienna. 2008. Occupational Radiation Protection Series: IAEA Safety Standards Series, 2018. Vienna. ISSN 1020-525X; no. GSG-7. Occupational Radiation Protection Series: IAEA Safety Standards Series, 2018. Vienna. ISSN 1020-525X; no. GSG-7. Predisposal management of radioactive waste from nuclear power plants and research reactors. Series: IAEA Safety Standards Series, 2016 . Vienna. ISSN 1020-525X; no. SSG-40. Predisposal management of radioactive waste from nuclear power plants and research reactors. Series: IAEA Safety Standards Series, 2016 . Vienna. ISSN 1020-525X; no. SSG-40. Основополагающие принципы безопасности. Серия норм безопасности. Пер. с англ. 2015. № SF-1 [Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards IAEA Safety Standards Series, 2014. Vienna; no. GSR Part 3. (In Russian)]. Osnovopolagayuschie principy bezopasnosti. Seriya norm bezopasnosti. Per. s angl. 2015. № SF-1 [Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards IAEA Safety Standards Series, 2014. Vienna; no. GSR Part 3. (In Russian)]. Methods for Assessing Occupational Radiation Doses due to Intakes of Radionuclides. Safety Reports Series No. 37. 2004. IAEA. Vienna. Methods for Assessing Occupational Radiation Doses due to Intakes of Radionuclides. Safety Reports Series No. 37. 2004. IAEA. Vienna. МУ 2.6.1.1892-04. Гигиенические требования по обеспечению радиационной безопасности при проведении радионуклидной диагностики с помощью радиофармпрепаратов. [MU 2.6.1.1892-04. Hygienic requirements for ensuring radiation safety during radionuclide diagnostics using radiopharmaceuticals. (In Russian)]. MU 2.6.1.1892-04. Gigienicheskie trebovaniya po obespecheniyu radiacionnoy bezopasnosti pri provedenii radionuklidnoy diagnostiki s pomosch'yu radiofarmpreparatov. [MU 2.6.1.1892-04. Hygienic requirements for ensuring radiation safety during radionuclide diagnostics using radiopharmaceuticals. (In Russian)]. СанПиН 2.6.1.2368-08. Гигиенические требования по обеспечению радиационной безопасности при проведении лучевой терапии с помощью открытых радионуклидных источников. [SanPiN 2.6.1.2368-08. Hygienic requirements for ensuring radiation safety during radiation therapy using open radionuclide sources. (In Russian)]. SanPiN 2.6.1.2368-08. Gigienicheskie trebovaniya po obespecheniyu radiacionnoy bezopasnosti pri provedenii luchevoy terapii s pomosch'yu otkrytyh radionuklidnyh istochnikov. [SanPiN 2.6.1.2368-08. Hygienic requirements for ensuring radiation safety during radiation therapy using open radionuclide sources. (In Russian)]. СанПиН 2.6.1.3288-15. Гигиенические требования по обеспечению радиационной безопасности при подготовке и проведении позитронной эмиссионной томографии. [SanPiN 2.6.1.3288-15. Hygienic requirements for ensuring radiation safety in the preparation and conduct of positron emission tomography. (In Russian)]. SanPiN 2.6.1.3288-15. Gigienicheskie trebovaniya po obespecheniyu radiacionnoy bezopasnosti pri podgotovke i provedenii pozitronnoy emissionnoy tomografii. [SanPiN 2.6.1.3288-15. Hygienic requirements for ensuring radiation safety in the preparation and conduct of positron emission tomography. (In Russian)]. МУ 2.6.1.2808-10. Обеспечение радиационной безопасности при проведении радионуклидной диагностики методами радиоиммунного анализа in vitro. [MU 2.6.1.2808-10. Ensuring radiation safety during radionuclide diagnostics using in vitro radioimmunoassay methods. (In Russian)]. MU 2.6.1.2808-10. Obespechenie radiacionnoy bezopasnosti pri provedenii radionuklidnoy diagnostiki metodami radioimmunnogo analiza in vitro. [MU 2.6.1.2808-10. Ensuring radiation safety during radionuclide diagnostics using in vitro radioimmunoassay methods. (In Russian)]. Наркевич БЯ, Малаева НС, Зиновьева НП. Радиоактивная загрязненность рабочих поверхностей «чистыми» гамма-излучателями: Концепция и технология нормирования. Медицинская физика 2000; (8): 40-7. [Narkevich BYa., Malaeva NS, Zinovieva NP. Radioactive contamination surfaces with "clean" gamma emitters: Concept and standardization technology. Medical Physics 2000; (8): 40-7. (In Russian)]. Narkevich BYa, Malaeva NS, Zinov'eva NP. Radioaktivnaya zagryaznennost' rabochih poverhnostey «chistymi» gamma-izluchatelyami: Koncepciya i tehnologiya normirovaniya. Medicinskaya fizika 2000; (8): 40-7. [Narkevich BYa., Malaeva NS, Zinovieva NP. Radioactive contamination surfaces with "clean" gamma emitters: Concept and standardization technology. Medical Physics 2000; (8): 40-7. (In Russian)]. Covens P, Berus D, Caveliers V, Struelens L, Verellen D. Skin contamination of nuclear medicine technologists: incidence, routes, dosimetry and decontamination. Nucl Med Commun. 2012 Oct; 33(10):1024-31.DOI:10.1097/MNM.0b013e32835674d9. Covens P, Berus D, Caveliers V, Struelens L, Verellen D. Skin contamination of nuclear medicine technologists: incidence, routes, dosimetry and decontamination. Nucl Med Commun. 2012 Oct; 33(10):1024-31.DOI:10.1097/MNM.0b013e32835674d9. Bernier MO, Journy N, Villoing D, et al. Cataract Risk in a Cohort of U.S. Radiologic Technologists Performing Nuclear Medicine Procedures. Radiology. 2018 February; 286(2): 592-601. Bernier MO, Journy N, Villoing D, et al. Cataract Risk in a Cohort of U.S. Radiologic Technologists Performing Nuclear Medicine Procedures. Radiology. 2018 February; 286(2): 592-601. Наркевич БЯ, Лысак ЮВ. Оптимизация использования радионуклидных генераторов в ядерной медицине. Медицинская физика. 2018; (1): 89-95. [Narkevich BYa, Lysak YuV. Optimization of the use of radionuclide generators in nuclear medicine. Medical Physics. 2018; (1): 89-95. (In Russian)]. Narkevich BYa, Lysak YuV. Optimizaciya ispol'zovaniya radionuklidnyh generatorov v yadernoy medicine. Medicinskaya fizika. 2018; (1): 89-95. [Narkevich BYa, Lysak YuV. Optimization of the use of radionuclide generators in nuclear medicine. Medical Physics. 2018; (1): 89-95. (In Russian)]. Krille L, Hammer GP, Merzenich H, Zeeb H. Systematic review on physician's knowledge about radiation doses and radiation risks of computed tomography. Eur J Radiol. 2010 Oct;76(1):36-41. DOI: 10.1016/j.ejrad.2010.08.025. Krille L, Hammer GP, Merzenich H, Zeeb H. Systematic review on physician's knowledge about radiation doses and radiation risks of computed tomography. Eur J Radiol. 2010 Oct;76(1):36-41. DOI: 10.1016/j.ejrad.2010.08.025. Kasraie N, Jordan D, Keup Ch, Westra S. Optimizing Communication with Parents on Benefits and Radiation Risks in Pediatric Imaging. J Am Coll Radiol 2018; 15(5):1-9. DOI: 10.1016/ j.jacr.2018.01.032 Kasraie N, Jordan D, Keup Ch, Westra S. Optimizing Communication with Parents on Benefits and Radiation Risks in Pediatric Imaging. J Am Coll Radiol 2018; 15(5):1-9. DOI: 10.1016/ j.jacr.2018.01.032 Наркевич БЯ, Хмелев АВ, Крылов ВВ, Кочетова ТЮ. Разработка краткого словаря по ядерной медицине. Медицинская радиология и радиационная безопасность. 2020; 65(2): 68-81.[Narkevich BYa, Khmelev AB, Krylov VV, Kochetova TYu. Development of the concise vocabulary in nuclear medicine. Medical Radiology and Radiation Safety. 2020; 65 (2): 68-81. (In Russian)]. Narkevich BYa, Hmelev AV, Krylov VV, Kochetova TYu. Razrabotka kratkogo slovarya po yadernoy medicine. Medicinskaya radiologiya i radiacionnaya bezopasnost'. 2020; 65(2): 68-81.[Narkevich BYa, Khmelev AB, Krylov VV, Kochetova TYu. Development of the concise vocabulary in nuclear medicine. Medical Radiology and Radiation Safety. 2020; 65 (2): 68-81. (In Russian)]. ICRP Publication 60. 1990 Recommendations of the International Commission on Radiological Protection. Ann. ICRP. 1990; 21(1-3). ICRP Publication 60. 1990 Recommendations of the International Commission on Radiological Protection. Ann. ICRP. 1990; 21(1-3). Публикация 103 МКРЗ. Рекомендации 2007 года Международной комиссии по радиационной защите. Пер. с англ. М.: Изд. ООО ПКФ «Алана». 2009. 344 с. [ICRP Publication 103. The 2007 Recommendations of the International Commission on Radiological Protection.. Ann. ICRP 2007; 37(2-4). (In Russian)]. Publikaciya 103 MKRZ. Rekomendacii 2007 goda Mezhdunarodnoy komissii po radiacionnoy zaschite. Per. s angl. M.: Izd. OOO PKF «Alana». 2009. 344 s. [ICRP Publication 103. The 2007 Recommendations of the International Commission on Radiological Protection.. Ann. ICRP 2007; 37(2-4). (In Russian)]. Мониторинг окружающей среды и источников для целей радиационной защиты. Пер. с англ. 2016. МАГАТЭ, Вена. [Environmental and Source Monitoring for Purposes of Radiation Protection Safety Guide. no. RS-G-1.8. 2015. IAEA, Vienna. (In Russian)]. Monitoring okruzhayuschey sredy i istochnikov dlya celey radiacionnoy zaschity. Per. s angl. 2016. MAGATE, Vena. [Environmental and Source Monitoring for Purposes of Radiation Protection Safety Guide. no. RS-G-1.8. 2015. IAEA, Vienna. (In Russian)]. Radiation protection and safety in medical uses of ionizing radiation. Series: IAEA Safety Standards Series. 2018. IAEA. Vienna. ISSN 1020-525X; no. SSG-46. Radiation protection and safety in medical uses of ionizing radiation. Series: IAEA Safety Standards Series. 2018. IAEA. Vienna. ISSN 1020-525X; no. SSG-46. Радиационный контроль радиоактивных сбросов в окружающую среду. Пер. с англ. 2005. МАГАТЭ, Вена. [Regulatory Control of Radioactive Discharges to the Environment. Safety Guide no. WS-G-2.3. 2004. IAEA. Vienna. (In Russian)]. Radiacionnyy kontrol' radioaktivnyh sbrosov v okruzhayuschuyu sredu. Per. s angl. 2005. MAGATE, Vena. [Regulatory Control of Radioactive Discharges to the Environment. Safety Guide no. WS-G-2.3. 2004. IAEA. Vienna. (In Russian)]. Classification of Radioactive Waste: Safety Guide. Safety Standards Series No. no. GSG-1. IAEA. Vienna. 2009. Classification of Radioactive Waste: Safety Guide. Safety Standards Series No. no. GSG-1. IAEA. Vienna. 2009. Release of Patients after Radionuclide Therapy. Safety Reports Series No.63. IAEA. Vienna. 2009. Release of Patients after Radionuclide Therapy. Safety Reports Series No.63. IAEA. Vienna. 2009. ICRP Publication 94. Release of Patients after Therapy with Unsealed Radionuclides. Ann. ICRP. Vol. 34. № 2. ICRP Publication 94. Release of Patients after Therapy with Unsealed Radionuclides. Ann. ICRP. Vol. 34. № 2. Наркевич БЯ, Ширяев СВ, Клепов АН, Липанова НН, Лысак ЮВ. Радиационно-гигиеническое обоснование радионуклидной терапии в амбулаторном режиме. Радиационная гигиена. 2014; 7(2): 47-58. [Narkevich BYa, Shiryaev SV, Klepov AN, Lipanova NN, Lysak YuV. Radiation-hygienic substantiation of radionuclide therapy on an outpatient basis. Radiation Hygiene. 2014; 7 (2): 47-58. (In Russian)]. Narkevich BYa, Shiryaev SV, Klepov AN, Lipanova NN, Lysak YuV. Radiacionno-gigienicheskoe obosnovanie radionuklidnoy terapii v ambulatornom rezhime. Radiacionnaya gigiena. 2014; 7(2): 47-58. [Narkevich BYa, Shiryaev SV, Klepov AN, Lipanova NN, Lysak YuV. Radiation-hygienic substantiation of radionuclide therapy on an outpatient basis. Radiation Hygiene. 2014; 7 (2): 47-58. (In Russian)]. Заключение Российской научной комиссии по радиологической защите по результатам заседания 13 мая 2019 г. Радиация и риск. 2019; 28(2):5-7. [Conclusion of the Russian Scientific Commission on Radiological Protection based on the results of the meeting on May 13, 2019. Radiation and Risk. 2019; 28 (2): 5-7. (In Russian)]. Zaklyuchenie Rossiyskoy nauchnoy komissii po radiologicheskoy zaschite po rezul'tatam zasedaniya 13 maya 2019 g. Radiaciya i risk. 2019; 28(2):5-7. [Conclusion of the Russian Scientific Commission on Radiological Protection based on the results of the meeting on May 13, 2019. Radiation and Risk. 2019; 28 (2): 5-7. (In Russian)]. Основные санитарные правила обеспечения радиационной безопасности ОСПОРБ-99/2010. СП 2.6.1.2612-10. (В ред. изменений № 1, утв. постановлением Главного государственного санитарного врача РФ от 16.09.2013 № 43). [Basic sanitary rules for ensuring radiation safety OSPORB-99/2010. SP 2.6.1.2612-10. (As amended by No. 1, approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation No. 43 of September 16, 2013). (In Russian)]. Osnovnye sanitarnye pravila obespecheniya radiacionnoy bezopasnosti OSPORB-99/2010. SP 2.6.1.2612-10. (V red. izmeneniy № 1, utv. postanovleniem Glavnogo gosudarstvennogo sanitarnogo vracha RF ot 16.09.2013 № 43). [Basic sanitary rules for ensuring radiation safety OSPORB-99/2010. SP 2.6.1.2612-10. (As amended by No. 1, approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation No. 43 of September 16, 2013). (In Russian)]. Наркевич БЯ, Ширяев СВ, Крылов ВВ. Повышает ли новая версия ОСПОРБ-99/2009 уровень радиационной безопасности в медицине? Медицинская радиология и радиационная безопасность. 2015; 60(6):5-9. [Narkevich BY, Shiryaev SV, Krylov VV. Does the new version of OSPORB-99/2009 increase the level of radiation safety in medicine? Medical Radiology and Radiation Safety. 2015; 60(6): 5-9. (In Russian)]. Narkevich BYa, Shiryaev SV, Krylov VV. Povyshaet li novaya versiya OSPORB-99/2009 uroven' radiacionnoy bezopasnosti v medicine? Medicinskaya radiologiya i radiacionnaya bezopasnost'. 2015; 60(6):5-9. [Narkevich BY, Shiryaev SV, Krylov VV. Does the new version of OSPORB-99/2009 increase the level of radiation safety in medicine? Medical Radiology and Radiation Safety. 2015; 60(6): 5-9. (In Russian)]. Наркевич БЯ, Лысак ЮВ, Коновалов ИС, Ширяев СВ, Крылов ВВ. Расчетные исследования проектной мощности станции очистки жидких радиоактивных отходов в подразделениях радионуклидной терапии. Медицинская физика. 2915; (4):60-8. [Narkevich BYa, Lysak YuV, Konovalov IS, Shyryaev SV, Krylov VV. Computational studies of the design capacity of a liquid radioactive waste treatment station in radionuclide therapy units. Medical Physics. 2915; (4): 60-8. (In Russian)]. Narkevich BYa, Lysak YuV, Konovalov IS, Shiryaev SV, Krylov VV. Raschetnye issledovaniya proektnoy moschnosti stancii ochistki zhidkih radioaktivnyh othodov v podrazdeleniyah radionuklidnoy terapii. Medicinskaya fizika. 2915; (4):60-8. [Narkevich BYa, Lysak YuV, Konovalov IS, Shyryaev SV, Krylov VV. Computational studies of the design capacity of a liquid radioactive waste treatment station in radionuclide therapy units. Medical Physics. 2915; (4): 60-8. (In Russian)].